As a Hearing Officer, to determine refusal of medication by the patient, what sections of the medical record are permissible to review?
If there are any limitations on what can be reviewed, please state those limitations.
Don SuttonJanuary 20, 2011 | Don Sutton
Don: I put no limits on what can be read from the chart in Cert hearings. Is there some reason you think there should be limits in Riese Hearings?
Joe MeltonMay 3, 2012 | Joseph MeltonI believe that when this issue came up Don and I discussed it through email, but since Joe commented on it I will add mine. Unlike cert hearings the rules of evidence actually apply in Riese hearings although I never really enforce them strictly. Even lawyers have problem understanding hearsay among other rules. Anyway, with refusal issue aside from the doctor’s testimony I will look at the patient’s medication administration records (MAR)if necessary, but I rarely need to do so since the doctor can read it much better than I.
May 3, 2012 | Hoa Glassey
Although I agree with Hoa that evidence rules can be confusing there are cases I’ve had where the doctor could not establish clear and convincing evidence without relying on hearsay about the patient’s conduct e.g.. at home. In L.A., for Riese hearings we can use this hearsay only to support the doctor’s diagnosis and treatment plan, not as to the truth of what e.g.. mother said. If nothing has occurred in the hospital, there’s your problem finding clear and convincing evidence regardless of how much is read from the chart.
P.S. The hospital appealed my denial and had the mother testify in court, overcoming the hearsay objection.
Also, in L.A.,the hearing officer does not review the medical record. Sometimes a specific letter etc. will be submitted into evidence, which we do read.
You have to hear the evidence read out of the chart to make a ruling. From that standpoint everything is potentially readable.
August 20, 2012 | Frank Ciafone